School phy


Meridian, ID
Best answers
I put a questioned out there for cpt code for school physicals, and never got an answer, if anyone could help on this, would appreciate it.

I'll offer my opinion here....

If the school physical is performed as part of the child's annual wellness exam, or the exam meets the criteria for a wellness exam, then I agree you would report the age-appropriate preventative medicine E/M code. You would not report the office/outpatient E/M codes of 99201-99215 because these are problem-oriented visits, and usually with a school physicial, the patient is asymptomatic.

If the school physicial does not meet the criteria for a preventative medicine exam or is performed outside of the patient's annual wellness exam, you would report 99499 (unlisted E/M). It has been my experience that most insurance won't cover school physicals, so you may have to make them a cash visit.

Hope this helps.